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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ7692621; ADJ7687042
Regular
May 17, 2012

FREDDY TORRES vs. SCOTT BROS DAIRY INC.; ILLINOIS MIDWEST SPRINGFIELD

This case involves a dispute over the selection of a Qualified Medical Evaluator (QME). The defendant attempted to strike a QME from the panel prematurely, violating Labor Code section 4062.2(c). The applicant's subsequent strike was timely, leaving only Dr. Katz on the panel. The Appeals Board denied the defendant's Petition for Removal, upholding the WCJ's order for an evaluation by Dr. Katz. The Board warned the defendant that denying benefits based on Dr. Katz's report would be at their peril.

Petition for RemovalQualified Medical EvaluationLabor Code Section 4062.2(c)QME PanelAgreed Medical EvaluatorStrike a NameTimely StrikePremature StrikeMedical DirectorDivision of Workers' Compensation
References
Case No. MNKOI 0000714498
Regular
Jul 03, 2018

SALVADOR MOTA vs. BOSKOVICH FARMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Workers' Compensation Appeals Board denied CIGA's petition for reconsideration regarding a lien claim. CIGA argued the lien was barred by Insurance Code section 1063.1(c)(9) because the claimant, VQ Ortho/Vision Quest Industries, Inc. (VQ), was an assignee. However, the Board found VQ was the original claimant who had temporarily assigned and then reassigned the claim back to itself. This allowed VQ to assert the lien as the original provider of services, consistent with the legislative intent of CIGA to protect original claimants.

CIGACovered ClaimInsurance Code 1063.1(c)(9)AssigneeOriginal ClaimantLien ClaimReconsiderationWCABWCJVQ Ortho/Vision Quest Industries
References
Case No. ADJ8782096, ADJ8782101
Regular
Dec 10, 2019

MKRTICH BUKUJIAN vs. STATE OF CALIFORNIA, DEPARTMENT OF SOCIAL SERVICES; IHSS

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the WCJ's decision. The WCJ's report explained that the applicant failed to prove industrial injury for GERD, as medical opinions identified significant pre-existing non-industrial factors. Additionally, the WCJ properly relied on the orthopaedic PQME for right knee impairment, as that physician obtained a more complete medical history including a prior surgery. The applicant also failed to demonstrate continuous trauma psychiatric impairment beyond what was awarded for the specific injury.

WCABPetition for ReconsiderationSubstantial EvidencePhysician OpinionContinuous TraumaSpecific InjuryPermanent DisabilityPsyche InjuryGERDOrtho PQME
References
Case No. ADJ8148530
Regular
Jan 11, 2013

MIGUEL ALDEREGUIA CAPETILLO vs. CARDENAS MARKETS, CARL WARREN & COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior decision, adopting and incorporating the Judge's report. The WCAB affirmed the original decision but amended it to disallow specific liens from various entities. The Board also advised the lien claimants' attorney to follow procedural rules for future filings by including their state bar number.

WCABReconsiderationAdministrative Law JudgePetitionLien ClaimantsRule 10845Rule 10232(a)(4)State Bar Membership NumberEmployment Development DepartmentNew Age Pharmaceuticals
References
Case No. ADJ6951416
Regular
Apr 22, 2013

BRETTEN JOHNSON vs. ROBERTSON'S READY MIX CONCRETE

The Workers' Compensation Appeals Board granted reconsideration of an order dismissing a lien claimant's claim for failure to pay an activation fee prior to a lien conference. The lien claimant alleged proof of payment was presented, but the WCJ stated no such proof was offered and the fee was not reflected in the system at the time. The Board is considering sanctions against the lien claimant's representatives for alleged misrepresentations and filing frivolous positions, finding the petition lacked record support and contained potentially false statements. A decision on the merits of the lien claimant's petition is pending.

Lien activation feeWorkers' Compensation Appeals BoardLabor Code section 4903.06ReconsiderationSanctionsBad-faith actionsMisrepresentationsWCJHearing representativeEAMS
References
Case No. ADJ2544321 (VNO 0546971)
Regular
Jan 04, 2010

PEDRO SERRATO vs. B & B DOORS & WINDOWS, INC., PRAETORIAN INSURANCE COMPANY C/O AMERICAN ALL RISK LOSS ADMINISTRATORS

The Workers' Compensation Appeals Board dismissed the defendant's Petition for Reconsideration as untimely, as it was filed 44 days after the deadline. The Board, however, corrected a clerical error in the original Findings and Award. The Judge had awarded $12,425.48 to a lien claimant, but the corrected award reflects the statutory limit of 24 chiropractic visits, along with physical therapy and acupuncture, totaling $3,740.61 based on expert testimony.

Workers' Compensation Appeals BoardPedro SerratoB & B Doors & WindowsPraetorian Insurance CompanyPacific Ortho & RehabilitationFindings and Awardclerical errorpetition for reconsiderationuntimelyLabor Code section 5903
References
Case No. ADJ10589446
Regular
Sep 04, 2019

ROCÍO BRAVO vs. RAM-Z-FAM., INC., dba MCDONALDS, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA, BROADSPIRE

The Workers' Compensation Appeals Board granted the lien claimant's petition for reconsideration, rescinding a prior order that denied payment for medical services. The Board found that the employer's liability for medical treatment under Labor Code section 5402(c) begins the day after a claim form is filed. The case was returned to the trial level for further proceedings to determine if the applicant filed a claim form with the employer before the lien claimant provided services. This determination is crucial for establishing the employer's liability for the lien.

Workers' Compensation Appeals BoardROCIO BRAVORAM-Z-FAM.INC.TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICABROADSPIREADJ10589446Petition for ReconsiderationLien ClaimantFindings and Order
References
Case No. ADJ7447894, ADJ2955721 (GRO 0029571), ADJ3762879 (GRO 0029570)
Regular
Oct 29, 2015

Glenn Kendall vs. San Luis Personnel, State Compensation Insurance Fund

The Workers' Compensation Appeals Board dismissed a petition for reconsideration by lien claimants Dr. Moelleken and Carrillo Surgery Center. Initially, the administrative law judge dismissed their liens, but then vacated that dismissal after the lien claimants objected. As the original order was set aside, the petition for reconsideration became moot, leading to its dismissal by the Board.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ClaimantsAdministrative Law Judge (WCJ)Notice of Intention to Dismiss LiensVacated OrderLien ConferenceMoot PetitionDismissalSan Luis Personnel
References
Case No. ADJ9693769
Regular
Sep 26, 2022

AUGUSTO GARCIA vs. SIERRA TRAFFIC SERVICE, STATE COMPENSATION INSURANCE FUND

The Appeals Board reconsidered a decision and affirmed findings that the applicant sustained a heat stroke injury but not orthopedic injuries. The Board rescinded the award of temporary disability benefits, finding no substantial medical evidence supported disability resulting from the industrial injury. Consequently, the Employment Development Department is not entitled to reimbursement, and the lien of Spine and Ortho Center is disallowed.

Workers' Compensation Appeals BoardReconsiderationTemporary DisabilitySubstantial Medical EvidenceOrthopedic InjuryHeat StrokeDehydrationExhaustionSleep DisorderEmployment Development Department
References
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